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Individual

DR. MARK S. GURMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
791 AQUAHART RD, SUITE 200, GLEN BURNIE, MD 21061-3961
(240) 475-3911
Mailing address
791 AQUAHART RD, SUITE 200, GLEN BURNIE, MD 21061-3961
(240) 475-3911

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8738
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3126
CAREFIRST PROVIDER #
MD
01
521549203
TAX ID #
MD
01
568622
UNITED CONCORDIA PROVIDER
MD
Enumeration date
08/14/2006
Last updated
02/03/2011
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